The proposed research is part of a longitudinal study examining outcomes of children with otitis media (OM). The goals of the larger study are to use sophisticated procedures to document hearing and middle ear functioning, to measure factors that may exacerbate children?s inability to hear during OM-related hearing loss, and to examine the effects of quality of care in the home and daycare on children?s outcomes. The proposed project is a continuation of a currently funded postdoctoral fellowship examining pragmatic development and parental input of 12 and 24 month-old children with and without OM. The contribution of this research involves a longitudinal analysis using growth modeling to investigate children?s language and parental input at 12, 24 and 36 months. Participants will be 36-month-old children currently studied at 12 and 24 months. Parent-child interactions will be videotaped in the homes at 36 months. Longitudinal analysis using growth modeling will be used to investigate individual rate of change over time in children?s expression of intents and breakdowns, and parents? intents and clarification requests. If sufficient variation in within-person rate of growth is found, inter-individual models will be fit to the data to investigate whether OM predicts growth rate over time In children?s and parents? intents and breakdowns. Multiple regression will be used to investigate the effects of OM, parent input, and the OM x input interaction on children?s rate of language growth.